三种新辅助化疗在宫颈癌治疗中近期作用的比较

目的 评价三种新辅助化疗方案在宫颈癌治疗中近期作用的比较.方法 将71例需行新辅助化疗的宫颈癌患者按随机数字表法划分治疗方案:PF方案(顺铂、氟尿嘧啶,23例)、CBP方案(卡铂、博莱霉素、环磷酰胺,24例)、TP方案(紫杉醇、顺铂,24例),经过1～2个疗程化疗后,化疗有效患者于化疗后14～21 d手术,分析比较三种方案的疗效、不良反应;对手术及病理的影响.结果 TP、CBP、PF方案有效率分别为93.8%(30/32)、88.6%(31/35)、82.4%(28/34).年龄、病理分级、病理类型与疗效无关;但与临床分期有关.CBP方案术后病理显示未见癌残留率(28.6%,6/21)高于TP方案(4.3%,1/23)和PF方案(11.8%,2/17)(P<0.05).结论 三种新辅助化疗是安全、有效的治疗宫颈癌的方法,但三种方法各有优点,可根据患者的病情及经济情况选择合适的方案.

Comparison of three neoadjuvant chemotherapy in treating cervical carcinoma

Objective To explore the application value of neoadjuvant chemotherapy (NACT) in treating cervical carcinoma. Methods Seventy-one cervical carcinoma patients who were divided into three groups:PF group (cisplatin and fluorouracil,23 cases) or CBP group (carboplatin,bleomycetin and cyclophosphamide, 24 cases) or TP group (paclitaxel and cisplatin, 24 cases); operation was made 14 - 21 days afterwards. The therapeutic effect, chemotherapy side-effect and the effect on operation and pathology for these three groups were analyzed and compared. Results The effective rate was 93.8%(30/32),88.6% (31/35),82.4%(28/34) in TP group,CBP group,PF group,respectively. However, the therapeutic effect had no statistics significance with age, preoperative tumor grade, pathologic type for all the three groups, the therapeutic effect had statistical significance with clinical stage. The rate which pathological examination showed no residual cancer was biggest in CBP group [CBP group was 28.6%(6/21), TP group was 4.3% (1/23), PF group was 11.8%(2/17), P < 0.05 ]. Conclusions Three NACT projects are safe and effective treatment for cervical cancer. However,each project has advantages. The NACT projects can be elected for different patient according to his illness and economy.